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CHART N0. KZ�� 'c'9-s" <br /> everen <br /> e ;a.s;�j] <br /> City of Everett �2 `� � / / <br /> �� � <br /> Sewer Application and Permit � � <br /> No. 23411 12""9 <br /> DATE <br /> Z315 Fulton <br /> Service Address Utility Account No. <br /> nonc <br /> Billing Address Permit Fee <br /> City, State, Zip Connection Charge(s) <br /> none <br /> Owner (Mortgagor) Total Fee _ <br /> Billing Name <br /> Connection By City of Lveratt <br /> DON lIILLSR <br /> Address Signed __ <br /> cu:tomvr <br /> Phone <br /> DES:,RIPTION: Sewer District <br /> Lot 81ock <br /> Plat Monthly Sewer Service <br /> Unplatted Description Monthly Sewer Constr. <br /> Ty�e Permit: rePair <br /> Trunk <br /> Lateral <br /> Remarks: <br /> Abutting Lot Line <br /> N, S, E, W _ it. <br /> . /� <br /> _��� �Yi r/ . r S� S $ / r. fi. f?ARRr-:� <br /> • �/ Approved By <br /> � . n • �- / % � - . /-� ' 2 ':1 � f Ciry Enginccr <br /> s. Bonn <br /> Issued By _ _ <br /> /. �)/u � - � � /-' <br /> Inspection By =� � � � <br /> Date Inspected " - ' % '� ____ <br /> , <br /> SEE SKETCH ATTACHED N0. 23�I1 <br /> 'L� I !i <br />